玻璃体切除联合眼内镜下睫状体光凝治疗难治性青光眼

Endoscopic cyclophotocoagulation combined with vitrectomy for refractory glaucoma

目的评价玻璃体切除联合眼内镜下睫状体光凝术治疗难治性青光眼的效果。方法对10例（10只眼）难治性青光眼均行玻璃体切除术和晶状体切除后在眼内镜下行激光睫状体光凝，激光能量0．6～0．87／，时间0．5s，光凝下方180°～220°范围，光凝30～40点。结果术后随访6～15个月，10例眼压均控制在〈21mmHg（1mmHg=0．133kPa）。最佳矫正视力提高者7例，不变者1例，不配合者1例，1例睫状体光凝术中出现脉络膜下爆发性出血。结论玻璃体切除联合眼内镜下睫状体光凝治疗难治性青光眼是一种相对有效的方法。

Objective To evaluate the efficacy of endoscopic cyclophotocoagulation （ECP） com- bined with vitrectomy for refractory glaucoma. Methods Ten eyes of ten cases with refractory glaucoma were treated with ECP combined with vitrectomy. The scope of photocoagulation was 180^-220~ with energy 0.5-0.8 W and setting time of laser 0.5-1 s. All cases were followed up for 6-15 months with observation on visual acuity , intraocular pressure （IOP） control, complications during and after surgery. Results The IOP of all cases were lower than 21 mmHg without any anti-glaucoma drug. The best corrected visual acuity was improved in 7 cases and no changed in 1 case, decreased in 1 case. The subchoroidal expulsive hemor- rhage was observed during ECP in one eye. Conclusion ECP combined with vitrectomy in the treatment of refractory glaucoma is useful and safe. It improves the rate of surgery and preserves visual function, further- more its complications are few.